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low muscle tone in 5 month old
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low muscle tone in 5 month old

I have a five month old who has low muscle tone. He is a very social baby (smiles and coos a lot), but his motor skills are lagging. He does not roll over yet, cannot sit unsupported at all. He's still does not have great head control when held upright. His doc says that he has low muscle tone, but that it is a 'description', not a 'diagnosis' (whatever that means), and it is common in preemies (he was born 2 months early).

We try to do 'tummy time' to strengthen chest muscles, but he has reflux and does not like to be on his stomach. I'm not too concerned yet, but starting to worry, since his progress is slow. When might he outgrow this and 'catch up' to other babies his age? If it doesn't improve, could it be a sign of somthing else going on? Has anyone had child with this issue? Thx.
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Avatar_f_tn
I wouldn't worry. Being that he was 2 months premature has a lot to do with his "lagging" behind. He is really acting more like a 3 month old and not a 5 month old due to his prematurity. He will eventually catch up. Oh, and tummy time is very important.
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Avatar_f_tn
Keep putting him on his tummy.  Tummy time is actually not uncomfortable b/c of his reflux.  In fact, they're more comfy on their tummy b/c it burns less.  They just don't like tummy time in general.  He was 2 month earlier so I'd give him more time to catch up.  It's very rare when even a full term baby would sit up unsupported at 5 months of age.  He's still too young.  If you're very concerned, have him evaluated by a physical therapist.  I don't know what state you live in but some states have programs like early intervention or head start (0-3 years old) and your kid being born prematurely woul most likely be a good candidate for it.  It's a free for you.  Good luck.
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213739_tn?1215489609
My son also has low muscle tone, he's almost 3 and still has it.  We have been in physical therapy since he was 4 months old and he's done awesome!  The muscle tone also affects my little man's speech.  Like Me2mommy2b said, check out your state. We live in Missouri and have a program called First Steps and our little guy qualified for the program and they come to our house twice a week for speech, PT, OT, etc.  Right now we have 6 therapies a week but it's TOTALLY worth it and it's virtually free which is awesome!  Contact your local school district as they should have the information. I'd call the early childhood center for your school district if you have one.  I know for our program, they have to be 50% or more delayed to qualify and they come out and do an evaluation and decide. It's an absolutely amazing program.  I'd look into it- every bit helps!! Good luck and let me know if you need anything else!
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361951_tn?1220582583
Thanks to everyone for the comments.  To give an update, we do have the little guy seen by a therapist from a state program.  There was some staff turnover, but we have someone consistent for a month now, so that makes me feel better.  He's almost 6 months old now, doing just a little better, but definitely still has a lag with motor skills.  Our therapist says she is not a 'wait and see' type of person, but feels like it's still a little too early to know if anything is going on.  I brought up the possibility of CP (b/c left arm is often extended, and he doesn't bear weight in legs), but again, sounds like its a little soon to go down that path.  She said if he doesn't make much progress in next 3-4 months, then she's recommend a neuro consult.  To do an MRI, they have to sedate young babies, so waiting a little longer would avoid some risks of anesthesia.  Anyway, I like to hearing from others on this, just in case the docs or therapists aren't telling me everything they are thinking!
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167_tn?1374177417
It is not necessarily true that they have to sedate babies to do an MRI. My son had an MRI and he is just 5 months now. This was a few weeks ago. They told me that and then said we could try to feed him and get him to sleep. They gave us a dark room and had warm blankets ready for him. I handed him over, they wrapped him up, put him in the MRI and tried...he woke up. So the nurse took him and rocked him and walked around with him until he was asleep. They put him in and tried again, he woke up briefly, but quickly got used to the loud noises and slept through the whole 30 minute MRI. I would definitely try that if it comes to having to have an MRI. Also, don't be concerned with him not sitting yet, or other developmental milestones at this point because they can always catch up. It's too early to tell if there are issues with that. All you can do is remain hopeful and give him opportunities to have tummy time, play with toys and strengthen those muscles. Hopefully he will catch up and this will just be a memory!
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361951_tn?1220582583
Good to know that an MRI might not require sedation.  I will definitely keep that in mind, thanks.
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Avatar_n_tn
I wouldn't neccessarily worry just yet. My friend's baby, born at term is 6 months now and cannot sit, she is too twitchy if that makes sense and just falls over. She also has reflux and so doesn not do "tummy time" as it irritates her. Mom is not stressed and baby can reach for things and follows toys with her eyes. Just relax about it a bit for now, and do your central line excercises and your baby will soon catch up!
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373137_tn?1208100283
I am the mother of a 2 1/2 year old boy.  He had low muscle tone as a baby but did manage to reach certain milestones.  because of this underlying issue, he had an adverse reaction to aneasthesia and is now severely brain damaged.  If we had known about this underlying condition, certain preventative measures could be taken.  Never ever ignore neurological signs (low musle tone, funny jerks or spasms etc.).  Yes, it is too soon to say CP, but it is not too soon to start preventative measures and treatments.  My baby also had PT pre-op, was seen by so many doctors prior to and every single person downplayed his condition.  Your boy has relux together with low muscle tone, chances are that he is not swallowing great either (something only a milk scan can pick up) and the chances of him developing aspiration pneumonia (where his milk etc goes into the lungs - literally drops!!) is very very real and is potentially deadly and very preventable.  Don't let doctors downplay the symptoms.  Have the MRI, have the milkscan, have an EEG.  Make sure.  Better safe than so terribly sorry.  Good luck to you, I hope that this is purely because he was a bit premature, but it worries me tremendously that he doesn't have head control yet at 5 months.  
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373137_tn?1208100283
Sorry, forgot to say that the tummy time issue is not because of his reflux but rather because he feels he is smothering due to his low muscle town.  Tummy time is important, very important, so important that he should spend most of his day on the floor on his tummy.  Play with him while you are on your tummy watching him, put toys in front of him etc.  I know it is hard not to feel sorry for them and turn them over to their backs where they seem more comfortable, but you have to be strong about this issue.  
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361951_tn?1220582583
Thanks for your comments.  Other parents seem so much more straightforward than doctors sometimes.  I'm going to bring up the tests you suggested when I take him in next week.  Although we have seen continued improvement (he's reaching and grabbing toys now and head control has improved), but I'm still concerned.  I didn't mention earlier that he has a twin sister.  She is doing more than him, so with such an obvious discrepency in progress, I'm anxious to know if more is going on.  I know it's not good practice to compare your children, but sometimes I can't help it!

Thanks again for the advice.  
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373137_tn?1208100283
Rather set your mind at ease.  Rather be on the safe side than sorry later that you didn't do more.  Good luck, I'm holding thumbs.
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Avatar_n_tn
My daughter has the exact same symptoms as your son.  She was diasgnosed as hypotoic.  Because of her sleepiness, my ped recommended we see a ped. neurologist.  She too has her arm extended with a clenched fist, bears no weight on legs and has low muscle tone.  The neuro ran a battery of tests for amino acids, hypothyroidism, etc...  They called me today to say some of the tests were not within the normal range and I should come in on next Tuesday.  I was wondering if you found anything else out about your son.  My daughter also starts physical therapy on Friday.  My ped was not overly concerned, but the neurologist seems to have some concerns.
Thanks.
Nicole
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361951_tn?1220582583
Sorry that you are going thru this.  I know it is tough to be in the middle of testing, and not know what, if anything, is going on.

We actually have our long awaited neuro appt next week.  I think this is just a consult, so don't know what to expect beyond that.  My son has improved a ton over the last 4 months, in part, from more intensive therapy.  He is almost 11 months now, and sits, crawls, and pulls to a stand.  He still has the low tone and some of his movements still seem awkward and unsymmetrical to me, which is why we are still following up.

How old is you daughter?  Was she a preemie or have any other complications at birth?  My son was 6-7 months before we started to see the big improvements--but once he got the head control and a little more trunk control, things started to fall into place.  The arm extension isn't as apparent anymore, but he still clenches his fist sometimes when trying to hold a bottle or sippy cup.

Sorry, I'm probably not much help except to say that therapy and some extra time (and patience) has really made a difference for my son.  Keep us posted on how the appt goes for you.
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Avatar_f_tn
my son is 19 months old he cannot sit stand or walk he does not hold his head I've been to every doctor there is and they say he is blind there is no diagnosis for him can some one help
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4484425_tn?1384231934
There are many syndromes or problems that could cause this so I hate to even guess. Have doctors ran tests to look at his DNA to make sure its not something to do with his chromosomes? Have they done a scan of his brain? These I would think could give answers to what's going on.
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